The Tumor-Stroma Ratio Is an Independent Predictor for Survival in Nasopharyngeal Cancer

Abstract

Background: The tumor-stroma ratio (TSR) has been identified as a new and practicable prognostic histological characteristic of solid tumors. The aim of this study was to evaluate the prognostic value of the TSR in nasopharyngeal cancer (NPC). Patients and Methods: A total of 93 patients who presented with NPC from 2004 to 2007 were studied. Radiotherapy with or without chemotherapy was administered according to their Union for International Cancer Control (UICC) stages. The TSR was assessed visually on hematoxylin and eosin-stained tissue sections of biopsy specimens by 2 independent observers. Results: The 5-year overall survival (OS) and disease-free survival (DFS) rates were 66.67% and 54.91%, respectively, in the stroma-poor group and 40.48% and 33.33%, respectively, in the stroma-rich group. Both the 5-year OS and DFS rates in the stroma-poor group were significantly better than those in the stroma-rich group (p < 0.05). In a multivariate analysis, the TSR was identified as a highly significant prognostic factor for the 5-year OS (hazard ratio (HR) 1.999; p = 0.030) and the 5-year DFS (HR 1.925; p = 0.042). Conclusion: Stroma-rich tumors were associated with poor prognosis and an increased risk of relapse, which may serve as a new prognostic histological characteristic in NPC.

Are disseminated tumor cells in bone marrow and tumor-stroma ratio clinically applicable for patients undergoing surgical resection of primary colorectal cancer? The Leiden MRD study

“…TSR is a relatively simple to apply and cheap cell-based parameter, which is a strong quality. Multiple other studies have confirmed significant prognostic implications of the TSR not only in colon cancer, but also in other solid tumors [37–42]. Further research using a larger prospective cohort should bring this parameter closer to implementation in the TNM classification system.…”

Association between tumor-stroma ratio and prognosis in solid tumor patients: a systematic review and meta-analysis

“…Initially, 176 papers were generated in the primary electronic search in major databases. According to the inclusion criteria, 14 eligible studies [10–23] with 15 datasets and published from 2007 to 2015 were included. The main characteristics of the included studies were listed in Table 1.…”

Diffusion-Weighted Imaging of Nasopharyngeal Carcinoma: Can Pretreatment DWI Predict Local Failure Based on Long-Term Outcome?

“…In regard to NPC, research now also shows that stroma-rich NPCs are associated with poor prognosis and an increased risk of relapse. 22 Therefore, it could be postulated that NPCs with high ADCs are more likely to have a poor outcome compared with those with low ADCs. Currently, there are only a few NPC DWI studies that have correlated diffusion parameters with tumor characteristics at diagnosis, such as T-stage, 23,24 early intratreatment response, 25 and posttreatment response.…”